POS1162 PREVALENCE AND IMPACT OF DERMATOLOGIC CONDITIONS IN PATIENTS WITH GOUT
Authors: J. Shiyayo, L. Padnick-Silver, B. Lamoreaux
Journal: Annals of the Rheumatic Diseases (2022)

Background Gout is the most common inflammatory arthritis in adults and affects approximately 3-5% of the population in Europe and the United States. 1 Chronic hyperuricemia leads to monosodium urate (MSU) crystal deposition in both joints and soft tissues, including the heart, eyes, kidney, skin, and liver. 2 Systemic manifestations of gout have been well-characterized, with dermatologic involvement typically described as subcutaneous tophi, miliary gout, gouty panniculitis, and gout nodulosis. 2 Other dermatologic conditions may occur more often in gout patients and provide better understanding of a patient’s overall condition. Objectives This claims-based study examined the prevalence of dermatological conditions in a large US population of gout patients. Patients with and without dermatologic conditions (identified by diagnosis codes) were compared to assess comorbidity burden, review healthcare utilization, and better understand the underlying consequences of dermatological manifestations of gout. Methods The Symphony 2012-2017 claims database was searched to identify patients with ≥1 ICD-9 or -10 gout code (ICD-9: 274.xx, ICD-10: M1*) using Bellweather software (PearlDiver Technologies™). All patients were in the database ≥1 year before and ≥2 years after first gout code (index). Patients were said to have a dermatologic condition if they had ≥1 diagnosis code for atopic dermatitis (ICD-9: 6918, ICD-10: L2*), psoriasis (ICD-9: 6961, ICD-10:L4*), osteomyelitis (ICD-9:73008, ICD-10: M86*), melanoma (ICD-9:1729, ICD-10: C43*), peripheral ulcers (ICD-9: 70710), varied cutaneous abscesses (ICD-9: 9829, ICD-10: L022*), or cellulitis (ICD-9:6826, ICD-10: L03*). Diagnosis code prevalence and healthcare utilization were examined and compared between those with/without a dermatological diagnosis code. Results Of the nearly 1.7 million identified gout patients, 29% had ≥1 dermatology diagnosis code. Patients with and without ≥1 dermatology code were of similar age at index (62.72 vs. 61.84 years) but those with ≥1 code were less often male (62% vs. 65%). The most common dermatological codes identified included cellulitis (10.7%), dermatitis (4.8%), psoriasis (2.2%), and osteomyelitis (2.1%, Table 1). Overall, comorbidity diagnosis codes were more prevalent in patients with ≥1 dermatology code, including hypertension, chronic kidney disease, cardiovascular disease, and type 2 diabetes (Table 1). Additionally, healthcare utilization and pain medication use were higher in gout patients with dermatological conditions despite similar ULT use. Table 1. Incidence of select dermatologic conditions in gout vs general US populations and comorbidity prevalence among gout patients with/without ≥1 dermatological diagnosis code. Dermatologic conditions Gout population General US population p-value Cellulitis, incidence, cases/100,000 person-yrs 1094 199 3 &lt;0.001 Osteomyelitis, incidence, cases/100,000 person-yrs 219 22 4 &lt;0.001 Gout pts with ≥1 dermatology code (N=488,356) Gout pts without a dermatology code (N=1,201,082) Age, years, mean ± SD 62.72 ± 12.35 61.84 ± 12.67 ---- Male, n (%) 305,012 (63%) 779,103 (65%) &lt;0.001 Comorbidity, n (%) Hypertension 446,577 (91%) 1,040,381 (87%) &lt;0.001 Chronic kidney disease 215,670 (44%) 408,826 (34%) &lt;0.001 Cardiovascular disease 358,930 (73%) 749,577 (62%) &lt;0.001 Type 2 diabetes 254,914 (52%) 435,911 (36%) &lt;0.001 Conclusion These claims-based analyses suggest the prevalence of dermatologic conditions other than those historically associated with gout. Additionally, gout patients with dermatologic conditions had higher comorbidity burden than those without. Therefore, as with other conditions, the skin may provide clues of a larger, systemic disease burden. References [1]Kuo CF, et al. Nat Rev Rheumatol 2015;11:649-62. [2]Khanna P, et al. J Clin Med 2020;9:3204. [3]McNamara DR, et al. Mayo Clin Proc 2007;82:817-21. [4]Momodu II, Savaliya V. Osteomyelitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 11, 2021. Disclosure of Interests Julie Shiyayo: None declared, Lissa Padnick-Silver Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics